While mild UTIs (urinary tract infections) usually go away on their own with sufficient hydration, most cases of moderate or recurrent UTIs may require medical treatment involving antibiotics (oral or intravenous for severe cases) and painkillers.
In order to determine what type of antibiotic you need, a urine sample is needed to identify the type of bacteria infecting your urinary tract. A urine culture is conducted on the sample, examining it for antibiotic sensitivity and specificity. It may take 3-4 days to get the results.
Once the culture results are back, depending on the sensitivity, your doctor may prescribe the following:
- Septran (Trimethoprim/sulfamethoxazole; sulfa drug group)
- Ciprofloxacin (Nitrofurantoin and norfloxacin; fluoroquinolone group)
- Cephalexin or Ceftriaxone (cephalosporin group)
- Faropenem (beta lactam group-resistant UTIs)
- Doxycycline and tetracyclines (macrolides group)
- Injectable antibiotics such as tobramycin, amikacin and gentamicin (aminoglycoside group)
What causes UTIs?
The vast majority of UTIs are caused by Escherichia coli (E. coli), a bacteria usually found in the digestive system. Chlamydia and mycoplasma bacteria can infect the urethra but not the bladder. UTIs occur when these microbes enter your kidneys, ureters, urinary bladder and urethra.
Types of UTIs include:
- Lower tract infections: These involve the urethra and urinary bladder (cystitis). Bacteria in the intestine is the main cause of lower UTIs. The bacteria spread from the anus to the urethra and bladder, where they grow, invade the tissue and cause infection.
- Upper tract infections: These involve the ureters and kidneys (pyelonephritis) and require hospitalization. Upper UTIs usually occur when bacteria travel up from the bladder into the kidneys. Sometimes, they occur when bacteria travel from other areas of the body through the bloodstream and settle in the kidneys. This is common in the elderly, people with diabetes and those with poor immunity.
What increases the risk of developing UTIs?
Factors that increase the likelihood of developing UTIs include:
- Sexual intercourse, especially if more frequent, intense and with multiple or new partners
- Diabetes mellitus
- Poor personal hygiene
- Problems emptying the bladder completely
- Having a urinary catheter
- Bowel incontinence
- Blocked flow of urine
- Kidney stones
- Procedures involving the urinary tract
- Suppressed immune system
- Immobility for a long period
- Use of spermicides and tampons
- Heavy use of antibiotics, which can disrupt the natural flora of the bowel and urinary tract
What are signs and symptoms of UTIs?
Signs and symptoms of UTIs vary depending on age, gender and what part of the urinary tract has been infected. Most common signs and symptoms include:
How are UTIs diagnosed?
If you have recurrent UTIs, your doctor may request further diagnostic testing to determine the cause. Tests include:
- Diagnostic imaging involves assessing the urinary tract using ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) scans.
- Urodynamics determines how well the urinary tract is storing and releasing urine.
- Cystoscopy allows your doctor to see inside your bladder and urethra with a camera lens, which is inserted through the urethra through a long thin tube.
- Intravenous pyelogram involves injecting a dye into your body that travels through your urinary tract taking an X-ray of your abdomen. The dye highlights your urinary tract on the X-ray image.
How are UTIs treated?
Sufficient hydration and suitable oral antibiotics are first-line treatments for urinary tract infections. Home remedies include:
- Consuming cranberry juice, probiotics and vitamin C
- Placing a heating pad on the abdomen to temporarily relieve pain and discomfort
For severe UTIs, the treatment may include intravenous antibiotics in the hospital.
How can you prevent developing a UTI?
Sexual intercourse introduces bacteria and other microbes from outside the body into the urinary tract. Practicing good sexual hygiene can help reduce the amount of bacteria transferred during sexual activity:
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